وثيقة تأمين جديدة

أكمل عرض السعر السابق

الرجاء ادخال الرقم الوطني الموحد
الرجاء ادخال البريد الإلكتروني
الرجاء ادخال بريد إليكتروني صالح
الرجاء إدخال رقم الجوال
+966
الرجاء إدخال رقم جوال صحيح

الرمز المرجعي

الرجاء إدخال الرمز المرجعي
أدخل الرقم

يرجى العلم أن السعر قد يتغير بناءً على الإفصاح الطبي وتفاصيل الأعضاء

لمحة عامة

تكافل الراجحي هي واحدة من الشركات القليلة في المملكة العربية السعودية التي تمتلك الموارد اللازمة لتقديم برامج رعاية صحية متكاملة وفعالة مثل بوليصة التأمين الصحي الموحدة ، والتي تتوافق تمامًا مع متطلبات مجلس الضمان الصحي

بلاتيني

ذهبي

فضي

أساسي

بلاتيني

ذهبي

فضي

أساسي

لمحة عن الوثيقة

تكافل الراجحي هي واحدة من أهم الشركات القليلة التي تمتلك الموارد اللازمة لتقديم برنامج رعاية صحّي متكامل وفعّال في المملكة العربية السعودية، والتي تتوافق جميع منتجاتها مع متطلبات مجلس التأمين الصحّي التعاوني.

تفاصيل الوثيقة

توفّر لك "وثيقة صاحب العمل الصحيّة الموحّدة" مجموعة ممتازة من خيارات الرعاية الصحيّة. ويُمكنك الاختيار من بين أربع وثائق مختلفة وعالية الجودة، والمتوافقة مع متطلبات مجلس الضمان الصحّي. يمكنك الاستفادة أنت وموظفيك وأفراد أسرتهم من الرعاية الصحيّة الاستثنائية من خلال مجموعة واسعة من مزوّدي الخدمة والمستشفيات، حيث ستحصل على الرعاية التي تناسب احتياجاتك. نقوم بإصدار بطاقات صحيّة شخصيّة لجميع المشتركين المُؤمّن عليهم في الوثيقة لضمان تلقّي الخدمة عند أيٍ من شركائنا من مزودي الخدمة.

أسعار منافسة

تفاصيل الوثيقة

المنافع

استفد من تأميننا الصحي الذي يغطي الحد الأدنى من التغطية والمنافع بحسب مجلس الضمان الصحي وبأسعار منافسة

جدول مقارنة التغطية


فوائد

بلاتيني

ذهبي

فضي

أساسي
Prior Approval Limits Prior Approval Limits
SR 1000
Prior Approval Limits
SR 500
Room & Board in the appointed medical Network Provider is 100% Room & Board in the appointed medical Network Provider is 100%
Regular Suite
Room & Board in the appointed medical Network Provider is 100%
Single Room
Room & Board in the appointed medical Network Provider is 100%
Shared Room
Room & Board outside the network of providers (in/out KSA): Room & Board outside the network of providers (in/out KSA):
Per Day SR 1000
Room & Board outside the network of providers (in/out KSA):
Per Day SR 800
Room & Board outside the network of providers (in/out KSA):
Per Day SR 600
Annual Limit (Sum Insured) Per Person Per Year (PPPY) including sublimits mentioned in the Policy (*Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand). Annual Limit (Sum Insured) Per Person Per Year (PPPY) including sublimits mentioned in the Policy (*Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand).
SR 1,000,000*
Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks. Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks.
Covered Emergency & Non-Emergency
Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks.
Covered Emergency
Territorial Scope: Extended to Worldwide in emergency cases only while on Business trips, Vacation and Holidays for upto 60 days in the aggregate. Territorial Scope: Extended to Worldwide in emergency cases only while on Business trips, Vacation and Holidays for upto 60 days in the aggregate.
KSA
Chronic & Pre-existing Conditions up to Policy Limit PPPY Chronic & Pre-existing Conditions up to Policy Limit PPPY
Covered
In-Patient Companion (for children below 12 years) Or when the case medically required subject to the treating physician In-Patient Companion (for children below 12 years) Or when the case medically required subject to the treating physician
Covered
Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion) Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion)
SR 25,000
Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion)
SR 20,000
Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion)
SR 15,000
Delivery complication: Delivery complication:
Covered
Pre term newly born babies coverage is up to policy annual limit from day one of the policy Pre term newly born babies coverage is up to policy annual limit from day one of the policy
Covered
Co-insurance /Deductible: The Insured/Patient will pay The Percentage mentioned as co-insurance against each and every Outpatient Claim.
In-Patient & Emergency Treatments In-Patient & Emergency Treatments
NIL
Minimum network of Hospitals and Clinics (MPN) Minimum network of Hospitals and Clinics (MPN)
20% up to SR 75
Clinics, Medical Centers, Labs, Pharmacies outside minimum network (OCN) Clinics, Medical Centers, Labs, Pharmacies outside minimum network (OCN)
20% up to SR 100
Hospitals outside minimum network (OHN) Hospitals outside minimum network (OHN)
20% up to SR 300
Generic, Over-the-counter drugs (OCT) and innovative treatment - with no generic alternative Generic, Over-the-counter drugs (OCT) and innovative treatment - with no generic alternative
20% up to SR 30
Innovative treatment - with a generic alternative Innovative treatment - with a generic alternative
50% (No Max Cap)
Consultation fees in the appointed Network providers. Consultation fees in the appointed Network providers.
Covered
Vaccinations for Children as specified by MOH up to (6) years of age Vaccinations for Children as specified by MOH up to (6) years of age
Covered
Dental Benefit 1200 SAR with NIL Deductible for Essential & Preventive Dentistry. 800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies Dental Benefit 1200 SAR with NIL Deductible for Essential & Preventive Dentistry. 800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies
SR 3,000
Dental Benefit 1200 SAR with NIL Deductible for Essential & Preventive Dentistry. 800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies
SR 2,500
Dental Benefit 1200 SAR with NIL Deductible for Essential & Preventive Dentistry. 800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies
SR 2,000
Optical: Frames & Medical Lenses up to PPPY (Only for those aged 14 years and less) Optical: Frames & Medical Lenses up to PPPY (Only for those aged 14 years and less)
SR 1,500
Optical: Frames & Medical Lenses up to PPPY (Only for those aged 14 years and less)
SR 1,000
Optical: Frames & Medical Lenses up to PPPY (Only for those aged 14 years and less)
SR 400
Renal Dialysis Renal Dialysis
SR 180,000
Kidney Transplant Kidney Transplant
SR 250,000
Hearing Aids Hearing Aids
SR 6,000
Ambulance: within the city limits / Borders Ambulance: within the city limits / Borders
Covered
Repatriation of bodily remains to Home Country Repatriation of bodily remains to Home Country
SR 10,000
Physiotherapy Physiotherapy
Covered
Physician Charges Limits inside the network
General Physician General Physician
Covered
Specialist I (Registrar ) Specialist I (Registrar )
Covered
Specialist I I(Senior Registrar) Specialist I I(Senior Registrar)
Covered
Consultant Consultant
Covered
Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties
Covered
Physician Charges Limits outside the network
General Physician General Physician
SR 50
Specialist I (Registrar ) Specialist I (Registrar )
SR 200
Specialist I I(Senior Registrar) Specialist I I(Senior Registrar)
SR 100
Consultant Consultant
SR 300
Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties
SR 500
CS / NVD '' IVF PREGNANCIES" Delivery Limit CS / NVD '' IVF PREGNANCIES" Delivery Limit
Covered
Cost of Transplanting Organs " Donor" Cost of Transplanting Organs " Donor"
SR 50,000
Alzheimer's Cases Alzheimer's Cases
SR 15,000
The cost of the national program to reduce disability for newborns to reduce disability The cost of the national program to reduce disability for newborns to reduce disability
SR 100,000
Disability Cases Disability Cases
SR 100,000
Obesity Operation Obesity Operation
SR 15,000 (with 20% Copayment up to Max 1000/SR)
Contraception (Hormonal Contraceptives Therapy and Intrauterine Devices) Contraception (Hormonal Contraceptives Therapy and Intrauterine Devices)
SR 1,500
Circumcision for newly born boys Circumcision for newly born boys
SR 500
Ear piercing for newly born girls Ear piercing for newly born girls
SR 300
Table of immunization of the Respiratory syncytial virus (RSV) approved by the Ministry of Health Table of immunization of the Respiratory syncytial virus (RSV) approved by the Ministry of Health
Covered
Coverage of the early screening program for hearing impairment and the program of congenital heart defects for all births. Coverage of the early screening program for hearing impairment and the program of congenital heart defects for all births.
Covered
Covering the operations of treating obesity through the process of quantifying the stomach only (Sleeve) in the case of BMI 45 (BMI) Covering the operations of treating obesity through the process of quantifying the stomach only (Sleeve) in the case of BMI 45 (BMI)
SR 20,000
Autism Cases Autism Cases
SR 50,000
Milk formula for infants up to 24 months of age, when medically necessary and as per the Internationally recognized indications. Milk formula for infants up to 24 months of age, when medically necessary and as per the Internationally recognized indications.
Covered
Cover the costs of psoriasis treatment Cover the costs of psoriasis treatment
Covered
Psychological disorders Psychological disorders
SR 50,000
Cover non-acute conditions with limit of (SR 5000) for 4 sessions with medicine Cover non-acute conditions with limit of (SR 5000) for 4 sessions with medicine
SR 15,000
Cost Of Cardiac Valves Failure Cost Of Cardiac Valves Failure
SR 150,000
Coverage of newborns on the mother's card up to a maximum of 30 days from the date of birth until they are added in the policy retroactively from the date of birth. Coverage of newborns on the mother's card up to a maximum of 30 days from the date of birth until they are added in the policy retroactively from the date of birth.
Covered
Adult Vaccination as per MOH (including Tdap, PCV13, PPSV23 and influenza vaccine) Adult Vaccination as per MOH (including Tdap, PCV13, PPSV23 and influenza vaccine)
Covered
Sexually Transmitted Diseases (STDs) Sexually Transmitted Diseases (STDs)
Covered
Periodic examinations / Screenings Periodic examinations / Screenings
Covered
Menopausal and Perimenopausal Health Care Menopausal and Perimenopausal Health Care
Covered
Telemedicine Telemedicine
Covered
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